Holinski Sebastian, Claus Benjamin, Alaaraj Nour, Dohmen Pascal Maria, Kirilova Kremena, Neumann Konrad, Uebelhack Ralf, Konertz Wolfgang
Department of Cardiovascular Surgery, Charite Hospital, Medical University, Berlin, Germany.
Med Sci Monit. 2008 Nov;14(11):PI53-7.
Reduction of cognitive function is a possible side effect after cardiac surgery using cardiopulmonary bypass. We investigated the cerebroprotective effect of piracetam on cognitive performance in patients undergoing coronary artery bypass surgery under cardiopulmonary bypass.
MATERIAL/METHODS: Patients scheduled for elective, primary and isolated coronary bypass surgery were randomised either to piracetam or placebo group. The study was performed in a double blind fashion. Patients received either 12 g piracetam or placebo at the beginning of the operation. Six neuropsychological subtests from the Syndrom Kurz Test and the Alzheimer's Disease Assessment Scale were performed preoperatively and on the third postoperative day. To assess the overall cognitive function and the degree of cognitive decline across all tests after surgery we combined the six test-scores by principal component analysis.
A total number of 120 patients were enrolled into the study. Preoperative overall cognitive function were not significantly different between the groups. The postoperative combined score of the neuropsychological tests showed a deterioration of cognitive function in both groups (placebo-pre: -0.06+/-0.99 vs placebo-post: -1.38+/-1.11; p<0.0005 and piracetam-pre: 0.06+/-1.02 vs piracetam-post: -0.65+/-0.93; p<0.0005). However, the piracetam patients performed significantly better compared to the placebo patients after the operation and had a less decline of overall cognitive function (p<0.0005).
Piracetam has a cerebroprotective effect in patients undergoing coronary artery bypass surgery with the use of cardiopulmonary bypass. It reduces an early postoperative substantial decline of neuropsychological abilities.
使用体外循环的心脏手术后，认知功能减退是一种可能的副作用。我们研究了吡拉西坦对接受体外循环冠状动脉搭桥手术患者认知功能的脑保护作用。
材料/方法：计划进行择期、初次和单纯冠状动脉搭桥手术的患者被随机分为吡拉西坦组或安慰剂组。研究采用双盲方式进行。患者在手术开始时接受12克吡拉西坦或安慰剂。术前及术后第三天进行了来自综合征简短测试和阿尔茨海默病评估量表的六项神经心理学子测试。为了评估手术后所有测试的整体认知功能和认知下降程度，我们通过主成分分析将六个测试分数合并。
共有120名患者纳入研究。术前两组的整体认知功能无显著差异。神经心理学测试的术后综合评分显示两组的认知功能均有下降（安慰剂组术前：-0.06±0.99 vs安慰剂组术后：-1.38±1.11；p<0.0005；吡拉西坦组术前：0.06±1.02 vs吡拉西坦组术后：-0.65±0.93；p<0.0005）。然而，术后吡拉西坦组患者的表现明显优于安慰剂组患者，且整体认知功能下降较少（p<0.0005）。
吡拉西坦对接受体外循环冠状动脉搭桥手术的患者具有脑保护作用。它减少了术后早期神经心理能力的大幅下降。
